延迟子宫切除在凶险性前置胎盘并发产后出血中的临床应用  

Clinical application of delay hysterectomy in pernicious placenta previa with postpartum hemorrhage

作　　者：李华珍[1] 陈敦金[2] 陈艳红[2] 钟柳英[2] 李翠苑 

机构地区：[1]广州医科大学附属第二医院,广东广州511447 [2]广州医科大学附属第三医院广州重症孕产妇救治中心广东省产科重大疾病重点实验室

出　　处：《中南医学科学杂志》2017年第6期576-579,共4页Medical Science Journal of Central South China

摘　　要：目的探讨延迟子宫切除在凶险性前置胎盘并发产后出血中的临床应用。方法凶险性前置胎盘并发产后出血行子宫切除患者90例,剖宫产后立即行子宫切除69例(即行切除组),进行保守治疗失败后再行子宫切除21例(延迟切除组)。比较两组手术时间、出血量及输血量、术后并发症。结果延迟切除组手术时间269.5±56.3 min长于即行切除组168.2±45.6 min。延迟切除组出血量4683.5±540.8 m L、输注红细胞悬液18.5±4.3U及新鲜冰冻血浆1783.5±220.8 m L均大于即行切除组3544.2±510.3 m L、12.2±3.6 U及1044.2±210.3 m L,两组术后并发症比较无统计学差异。结论凶险性前置胎盘并发产后出血患者行延迟子宫切除不会增加患者风险,但能减少子宫切除率,具有临床应用价值。Objective To explore clinical application of delay hysterectomy in pernicious placenta previa with postpartum hemorrhage. Methods Among 90 eases of placenta previa complicated postpartum hemorrhage hysterectomy, of whom 69 were submitted to cesarean section immediate hysterectomy （immediate hysterectomy group）, 21 to conservative treatment failure after hysterectomy （delayed hysterectomy group）. Operation time, blood loss and transfusion volume and postoperative complications of two groups were compared. Results Operating time （269.5±56.3） min in delayed hysterectomy group is longer than in the immediate hysterectomy group （ 168.2± 45.6） min.The amount of bleeding（ 4683.5±540. 8 ）mL, transfusion of red blood cell suspension （ 18.5 ± 4.3 ） U and fresh frozen plasma （ 1783.5± 220.8 ） mL in the delayed hysterectomy group which were more than those in the immediate hysterectomy group （3544.2±510.3 ）mL. （12.2± 3.6） U and （ 1044.2 ± 210.3）mL.There was no statistical difference between the two groups in postoperative complications. Conclusion Delayed hysterectomy in pernicious placenta previa with postpartum hemorrhage does not increase the risk of patients, but can reduce the uterus resection rate ,which have clinical application value.

关 键 词：凶险性前置胎盘 产后出血 子宫切除 

分 类 号：R714.46[医药卫生—妇产科学]